Effect of fascia activation technique in women having back pain after delivery

Phase 1

Completed

Conditions: Sequelae of complication of pregnancy, childbirth, and the puerperium,

Registration Number: CTRI/2023/10/058830

Lead Sponsor: KLE Academy of Higher Education and Research

Brief Summary: Postpartum pelvic girdle pain (PGP) is a prevalent condition stemming from pregnancy-related factors, with a substantial occurrence rate of 29.9%. Particularly, Indian women experience a notable prevalence of PGP, with 14.7% reporting pain within four weeks postpartum. Literatures suggest post-partum individuals seeking physical therapy (PT) beyond three months after delivery may experience minimal gains.

Stabilizing exercises focused on transverse abdominis (TrA) and pelvic floor muscle (PFM) activity play a pivotal role in improving lumbo-pelvic stability. Co-contracting TrA and PFM effectively reduces vertical sacroiliac joint (SIJ) sheer forces, thereby enhancing SIJ stability. Empirical evidence underscores that stabilization exercises significantly alleviate pain and enhance TrA and PFM activity in postpartum lumbo-pelvic pain cases.

Muscles and fascia are integral components of support and equilibrium. These changes during pregnancy cause asymmetrical tension lines which disrupt length-tension relationships, potentially affecting pelvic floor muscle action angles and contributing to an unstable sacroiliac joint. Furthermore, interventions targeting myofascial chains and interconnected connective tissues exhibit altered effects on strength and range of motion. For instance, the biceps femoris and erector spinae muscles, connected by the Sacro-tuberous ligament and lumbar fascia, form part of the superficial back line. Nevertheless, there is a scarcity of literature on myofascial meridian-based kinetic chain interventions for postpartum PGP.

This study aims to explore the impact of kinetic chain activation techniques on musculoskeletal stability, with a focus on the anterior and posterior structures maintaining equilibrium between the two, supporting pelvic stability. By delving into the effectiveness of myofascial meridian-based interventions, this research seeks to shed light on their potential in alleviating postpartum pelvic girdle pain and enhancing overall functional well-being.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: Female

Target Recruitment: 26

Inclusion Criteria

Vaginal delivery childbirth Both primiparous and multiparous The onset of pain during pregnancy or within 3 weeks after delivery PGP will be diagnosed on the basis of the following criteria: Pain experienced distal to L5 and pain in the pelvic girdle region between the posterior iliac crest and the gluteal fold, with or without radiation in the posterior thigh, and with and without pain in the symphysis Pain that is reproducible by at least two or more positive pelvic pain provocation tests (two tests bilaterally).
Pain when turning in bed.

Exclusion Criteria

Not willing to participate.
Complain of back pain before pregnancy.
Back pain indicating radiculopathy below knee A history of neoplasm or spinal surgery, spinal or pelvic fracture, spinal deformity, severe trauma.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
LUMBOPELVIC RHYTHM	BEFORE AND AFTER TREATMENT
FLEXICURVE FOR SPINAL CURVATURE ASSESSMENT	BEFORE AND AFTER TREATMENT
PELVIC INCLINOMETER	BEFORE AND AFTER TREATMENT
PRESSURE BIOFEEDBACK	BEFORE AND AFTER TREATMENT

Secondary Outcome Measures

Name	Time	Method
VERBAL ANALOGUE SCALE	PELVIC GIRDLE QUESTIONNAIRE

Trial Locations

Locations (1): Tertiary Care Hospital (Dr. Prabhakar Kore Hospital)
🇮🇳
Belgaum, KARNATAKA, India
Tertiary Care Hospital (Dr. Prabhakar Kore Hospital)
🇮🇳Belgaum, KARNATAKA, India
Dr Varsha Huddar
Principal investigator
07892677707
mahima99.jdr@gmail.com